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An analysis by Canadian and Australian scientists of 27 previous studies led them to conclude that there is a significant association between alcohol use and prostate cancer risk. The more men drink, the greater the risk. Even low levels of drinking (up to two drinks a day) were associated with an 8 to 23 percent higher risk of prostate cancer when compared to no drinking, the researchers said. However, they did not prove that drinking caused the prostate cancer risk to increase. Alcohol is a known risk factor for breast cancer and at least seven types of digestive system cancers, and alcohol may also increase the risk of cancers of the skin and pancreas, the researchers said.
Additional details can be found on the following linked article published November 16th in the U.S. National Library of Medicine’s Medline Plus. See also the following item from Prostate Cancer News Today, Nov. 21.
When you’re diagnosed with prostate cancer, the doctor will determine how far the disease has progressed and tell you what stage the cancer is in. The staging shows how the tumor has grown and if the cancer has spread to other parts of the body. It’s important to know this information so that patients can start the correct course of treatment.
Here are the four recognized stages of prostate cancer:
Stage 1 refers to an early-stage diagnosis of prostate cancer and means that the tumor is in just one-half or less of one side of the prostate. At this stage, the tumor cannot be picked up on any imaging machines and cannot be felt in a digital rectum exam. The cancer is still confined to the prostate and hasn’t spread to any other parts of the body. Stage 1 prostate cancer will have a Gleason score below six and a PSA score below 10.
Stage 2 prostate cancer is split into stage 2A and 2B. In stage 2A, the cancer will still be confined to one-half of one side of the prostate and won’t have spread. The Gleason score will be 7 or under, and the PSA score will be 20 or under. At this stage, it still won’t be picked up via imaging or a digital rectum exam.
Stage 2B prostate cancer can be felt with a digital rectum exam and is now able to be picked up with imaging techniques. The cancer has now spread to the other side of the prostate, but not to the lymph nodes or other parts of the body. It will have a Gleason score of 8 or higher and a PSA score of 20 or higher.
Stage 3 is when the cancer has spread from the prostate and could now be in the seminal vesicles, but the lymph nodes and other parts of the body remain unaffected. Both the Gleason score and the PSA score can be of any value at this point.
Stage 4 prostate cancer is where the cancer has spread into other tissues surrounding the prostate including the rectum, bladder, pelvic wall or the urethral sphincter. It may also have spread to the lymph nodes and other parts of the body. At this stage, the Gleason and PSA scores can be of any level.
Madison Vaccines Incorporated (MVI, see the linked news release), has begun a Phase 1 clinical trial for MVI-118 (pTVG-AR) in men with metastatic prostate cancer who are initiating androgen deprivation (hormonal) therapy (ADT). MVI-118 targets the human androgen receptor, the critical biological target responsible for driving prostate cancer progression and, in many cases, resistance to current therapies. MVI-118 is intended to provide persistent activation of immune system CD8+ T-cells that target the androgen receptor, a key tumor cell protein that is frequently and highly overexpressed as resistance to ADT emerges. MVI-118 is being developed to prolong the duration of disease control gained from standard androgen deprivation therapies thus delaying resistance to ADT. The trial will be conducted at the University of Wisconsin – Madison Carbone Cancer Center and two additional Medical Centers including Rutgers Cancer Institute in New Jersey. For an overview see the link in the Nov. 7th Prostate Cancer News Today.
This is MVI’s second prostate cancer vaccine, along with MVI-816 (pTVG-HP), MVI’s lead vaccine that has demonstrated clinical evidence of safety, immune activation and biological signals (PSA changes) of activity. Both MVI-816 and MVI-118 are plasmid DNA vaccines that differ from other vaccines because they can be rapidly and inexpensively manufactured, can be administered by simple intradermal injection, and are relatively more stable in storage.
MVI’s lead vaccine, MVI-816, is in a Phase 2 clinical trials in patients with early biochemically recurrent prostate cancer intended to delay the onset of metastatic disease after primary therapy. MVI-816 is also in a second clinical trial in advanced metastatic, hormone-resistant cancer that began this past summer pairing it with an immunomodulatory PD-1 inhibitor which enhances the immune system’s activity against cancer cells but does not work alone in prostate cancer. Final Phase 2 data on MVI-816, the lead vaccine, is expected in 2018. Both MVI-816 and MVI-118 are intended to address the anticipated surge in prostate cancers over the next two decades as “Baby Boomers” reach the age when men are most commonly diagnosed with the disease.
For MDI-118 clinical trial details concerning enrollment and other criteria, see the following link to the National Institutes of Health (NIH) ClinicalTrials.gov. Patients in the Phase 1 trial of MDI-118 must have metastatic prostate cancer (clinical stage D1 or D2 disease), with previously documented lymph node, soft tissue and/or bone metastases as evidenced by radiographic imaging (including CT (or MRI) of abdomen and pelvis and bone scans). Patients must have started androgen deprivation therapy at least one month (4 weeks) prior to enrollment and no more than six months (24 weeks) prior to enrollment. Patients must continue the androgen deprivation therapy throughout the study period, and patients are not permitted to change the type of androgen deprivation therapy during the course of investigational therapy.
It isn’t often that a research finding appears in 4-5 e mail or other publications but such is the case herein. Researchers at Stanford University School of Medicine published a study entitled “Association Between Androgen Deprivation Therapy and the Risk of Dementia” in the journal Journal of the American Medical Association Oncology. They reported that men treated with testosterone-lowering drugs for their prostate cancer are more than twice as likely to develop dementia as those not receiving such treatment, according to a study that reviewed the medical records of nearly 10,000 patients. But, the study only found an association between ADT and dementia risk, not cause and effect. The researchers advised however that men undergoing androgen therapy shouldn’t stop the treatment based on these findings because more studies are needed to verify this potential link.
Last year, the research team at Stanford discovered that testosterone-lowering treatment was linked to a higher risk of developing Alzheimer’s disease. Since Alzheimer’s is commonly confused with vascular dementia, the team decided to explore if the association held true when including all types of dementia.
They identified medical records of 9,272 men with prostate cancer who had been treated between 1994 and 2003, of which 1,829 received testosterone-lowering treatment. To make sure results became as robust as possible, they first removed all patients who had dementia at prostate cancer diagnosis. Then, they matched treated and untreated patients with the same disease stages, to make sure the comparisons were valid.
The team discovered that within five years, 7.9 percent of those receiving testosterone-targeting treatment had developed dementia. Among patients not receiving such treatment, the number was 3.5 percent.
The risk is real and, depending on the prior dementia history of the patient alternative treatment treatment may be considered, particularly in light of a recent prospective study from the U.K., which showed that prostate cancer patients had the same chances of survival within a 10-year time frame, whether they received aggressive treatment or active monitoring. Only 1% of men died during the 10 years, suggesting that monitoring may be as good as treatment, without causing side effects.
According to an article in the Oct. 13th MedlinePlus published by the U.S. National Library of Medicine, one possible explanation is that androgens like testosterone are believed to be very important for neuron [brain cell] health. In the brain, the ability of neurons to repair themselves and not die off, those are at least partially regulated by androgens. A very reasonable theory would be if you don’t have those androgens around to have that protective effect, you would be more susceptible to developing dementia.
Based on the findings, researchers argue it makes sense to identify those at risk for dementia before considering testosterone-lowering treatment. Researchers, however, underscored that the data are derived from medical records, and that prospective clinical trials ultimately are needed to remove any doubts that testosterone-lowering treatments may trigger cognitive decline.
A slightly more extensive article for health professionals was published in the October 21st issue of Cancernetwork, home of the journal Oncology.